Potassium levels in a range of foods and drinks consumed in Mauritius

Sudaxshina Murdan1*, Anshu Prakash Murdan2, Premawuttee Murdan3

1UCL School of Pharmacy, University College London, 29-39 Brunswick Square, London, WC1N 1AX, UK 2Department of Electrical and Electronic Engineering, University of Mauritius, Reduit, Mauritius 3Quatre Bords Road, Bon Accueil, Mauritius

* Corresponding author email: [email protected]

Introduction

Potassium is an essential mineral nutrient, and high potassium intake is associated with lower mortality risk [1]. Thus people are advised to increase their consumption of fruits and vegetables which are natural sources of potassium. Since potassium is readily excreted by people with normal kidney function, and based on estimates of the generally low potassium intakes in European and North American populations, no Tolerable Upper Intake Level (UL) has been set [2, 3].

However, certain groups of people, such as those with renal failure, are at risk of hyperkalemia [4] and people with chronic kidney disease, and on dialysis are advised to restrict their intake of potassium [5]. To help patients, a number of websites, such as [5-7] and publications, such as [8-10] provide the potassium levels in different foods. While these sources are very useful and much of the information is freely available on the web, there is a dearth of information about foods that are eaten in certain parts of the world, such as in the Republic of Mauritius.

The aim of this pilot study was therefore to measure the potassium levels in a sample of drinks and plant foods that are commonly consumed in the island Republic of Mauritius.

Rationale for the study: Kidney disease affects significant numbers of Mauritians. At the end of 2014, there were 1132 individuals on dialysis in Mauritius [11]. Diabetes - the principal cause of death in Mauritius (25% in 2014) [11] – is also known to be a major risk factor for kidney disease. This pilot study was conducted in April 2015 in order to identify foods and drinks that are naturally lower in potassium, and which would therefore be more user-friendly to individuals who need to restrict their potassium intake.

1

Method

The potassium content was measured using a portable potassium meter – Laquatwin from Horiba

(http://www.horiba.com/application/material-property-characterization/water-analysis/water-quality-electrochemistry- instrumentation/compact/details/b-731-laquatwin-compact-potassium-ion-meter-17163/)

The meter was used as per the Instruction Manual.

Drinks (thoroughly mixed) were directly placed on the sensor.

Solid foods were firstly blended with a small amount of tap water. The blend was then made up to 100ml and mixed. A few drops of this mixture was placed on the sensor. Sometimes it was necessary to strain the mixture to avoid the placement of solid material on the sensor.

Results

The tables below show the potassium concentrations in commonly used drinks and foods in Mauritius. These values are similar to values for the same foods measured in different parts of the world, and shows that the portable potassium meter and the methodology are reliable.

The results may be used by patients wishing to limit their potassium intake. However, it must be noted that more work needs to be done to repeat the measurements using more samples in order to obtain average and standard deviation values, and to analyse a larger range of commonly used foods and drinks in the Mauritian diet.

Disclaimer The results may be used by patients wishing to limit their potassium intake. The names of the fruits and vegetables used in this paper are those that are commonly used in Mauritius. It is recognised that scientific names are needed; however, these were not easy to obtain at this point. This pilot study was conducted for personal use and is published freely in the hope that a more thorough investigation will be conducted through official routes, and that the official results will be widely distributed to all those who are likely to benefit. The authors recommend that individuals who wish to restrict their potassium intake do so only under medical supervision. The authors cannot accept any liability for damages resulting from the use of these pilot results.

Dedication This work is dedicated to our dearest Mounou, Vidya Prakash Murdan.

2

Potassium concentration (mg of Drinks Name/source potassium per Litre of:) tap water Bon Accueil 1 Rose Hill 1 Curepipe 0

Bottled water Dasani sparkling 1 Evian still 2 Vital still 2 Crystal still 2 Vital sparkling 82

Fizzy drinks 2 soda water 3 passion 3 Coca Cola 9 Fanta orange 12 Eski Rouge (Fraise/Strawberry) 13 Mirinda orange 16 Pepsi 20

Fruit Juices/drinks SunUp Blackcurrant (diluted 1+5, as per instructions on bottle) 110 Sunquick Mandarin (diluted 1+9, as per instructions on bottle) 150 Grapetiser 100% reed grape juice sparkling (500ml bottle) 460 Grapetiser 100% reed grape juice sparkling (750ml bottle) 630 Monis 820 Ceres Nectars melba drink 1300 Sunny (100% Jus de Fruits Raisin/100% Fruit Juice Grape) 1500 100% Apple juice (500 ml bottle) 2200

Others Lucozade (Energy, Original) 66 San Pellegrino aranciata can 280 Tea (1 tablespoon in 1 mug) 610 Malta Guiness 610 Coffee (Nescafe Classic instant; 1 heaped teaspoon in 1 mug) 720 Dahi (lait caille, vanille) 1300 Dahi (lait caille, fraise) 1400 Dahi (lait caille, peche) 1400 Dahi (lait caille, amande) 1500 Red wine (Chateau Haut Coureau, Bordeaux) 1600 Coconut water (fresh coconut) 4700

3

Potassium concentration Fruits and (mg of Potassium in 100g of Vegetables Name in french/creole English name fruit/vegetable)

Green leafy vegetables brede Basmati 80 Petsai 180 brede Martin 340 brede Tom Pouce Pak Choi 450 brede Blanc 780 laitue lettuce 800 brede Chouchou 830 brede Cresson Watercress 1225 brede Malbar 1330 brede Epinard Spinach 1500 brede Songe 1530 brede Souflette 1720 brede Mouroung 2860

Other vegetables Beansprouts Beansprouts 70 Manioc Cassava 100 Samkot 100 Pipengaye (flesh only) 125 Patol 130 Chouchou 150 Poivron (jaune) Pepper (yellow) 150 Patisson 160 Pipengaye (skin only) 170 Giromon Squash 190 Concombre Cucumber 200 Choufleur Cauliflower 230 Calebasse/calabash Bottle gourd 260 Le Choux rouge Red cabbage 260 Violet 420 Sweet potato (white Patate (blanc a l'interieur) flesh inside) 460 Lalo Ladies fingers /okra 570 Baton Mouroung 575 Margoz (kerala) court Bitter gourd (short) 600 Tomate (pomme d'amour) Tomato 740 Aubergine (long and Bringel (long et mince) narrow type) 900 Rave (blanc) (Mouli) Radish 920 Carotte Carrot 1050 Bringel anguive 1070 Beterave Beetroot 1325 Arouille 1950 Pomme de terre Potato 2380

Local fruits Grenadine (poulpe) Passionfruit (pulp) 130 Carambole Starfruit 140 Papaye Papaya 180 Jambose 220 Jamblon 220 4

Fruit de Cithere 220 Goyave Guava 260 Pomegranate (seeds Grenade (seeds only) only) 280 Kumquat Kumquat 300 Banane Banana 330 Goyave de Chine a type of guava 425 Pamplemousses Grapefruit 450 Ananas Pineapple 600 Prune locale 670

Imported fruits Raisin (rouge) Grape (red) 130 Pomme (rouge) Apple (red) 160 Kiwi Kiwi 180 Raisin (vert) Grape (green) 190 Poire Pear 200 Pruneau Plum 335 Raisin (noir) Grape (black) 660

Cereals, Grains, Rice (white Basmati, nuts and Others Riz (Basmati blanc, cuit) cooked) 23 Cornflakes Cornflakes 70 Pain maison Bread (roll) 130 Oatflakes Oatflakes 180 Weetabix Weetabix 330 Sesame grain (grille) Sesame seed (grilled) 590 Pistache (bouill) Peanuts (boiled) 1090 Miscellaneous tulsi leaves 350 apanah leaves 100

1. Yang, Q., et al., Sodium and Potassium Intake and Mortality Among US Adults Prospective Data From the Third National Health and Nutrition Examination Survey. Archives of Internal Medicine, 2011. 171(13): p. 1183-1191. 2. Authority, E.F.S., Tolerable Upper Intake Levels for vitamins and minerals. 2006. 3. Medicine, I.o., Dietary reference intakes for water, potassium, sodium, chloride and sulfate. 2005, Washington DC: The National Academies Press. 4. Silver, L.D. and T.A. Farley, Sodium and Potassium Intake Mortality Effects and Policy Implications. Archives of Internal Medicine, 2011. 171(13): p. 1191-1192. 5. Foundation, N.K. Dietary guidelines for adults starting on hemodialysis. 2015 [cited 2015 12 May]; Available from: https://www.kidney.org/atoz/content/dietary_hemodialysis. 6. ANSES, TableCiqual. 2013. 7. Program, N.K.D.E., Tips for People with Chronic Kidney Disease - Potassium (Fact Sheet). 8. Chekri, R., et al., Calcium, magnesium, sodium and potassium levels in foodstuffs from the second French Total Diet Study. Journal of Food Composition and Analysis, 2012. 25(2): p. 97-107. 9. Tanase, C.M., et al., Sodium and potassium in composite food samples from the Canadian Total Diet Study. Journal of Food Composition and Analysis, 2011. 24(2): p. 237-243. 10. Arquette, C., Are There Fast-Food Choices for End-Stage Renal Disease Patients? A Look at Phosphorus and Potassium Content in Common Fast Foods. Journal of Renal Nutrition, 2014. 24(3): p. E19-E21. 11. Health Statistics Unit, M.o.H.Q.o.L., Mauritius. Health Statistic Report 2014; Available from: http://health.govmu.org/English/Statistics/Health/Mauritius/Pages/default.aspx.

5